Holistic dentistry is an approach to dental treatment that focuses on a patient’s health and safety while maintaining the standards of conventional dentistry. It is sometimes called "biological" dentistry or "biocompatible" dentistry. It acknowledges and deals with the mind, body and spirit of the patient, not just his or her "teeth".

In holistic dentistry there is an effort to find biocompatible materials to use to reduce toxicity for everyone, especially the chemically sensitive. Holistic dentistry is “mercury-free” or amalgam free”. Amalgam use is avoided in holistic dentistry due to concern about possible toxicity problems. Amalgam removal and replacement with natural-looking bonded materials is a common holistic dentistry treatment as well as a common cosmetic dentistry treatment. Detoxification, especially of residual mercury deposits in body tissues from amalgams is often done.

Silver Fillings vs. Tooth Colored Restorations

Controversy

Since its introduction onto this continent in the early 1800's, the use of a mixture of half silver and half mercury as dental "Amalgam" to fill teeth has created controversy. To this day the arguments continue. Much scientific research has been done, but the divisions seem to be so strong that those in favor of its use rationalize away the condemning research. Those against its use claim that politics and personal interest motivate amalgam's proponents.

Facts

Mercury is a known poison. It is, in fact, one of - if not the - most toxic of all the elements known! It is fact that mercury is fully one-half of the mass of the filling you see when you look at any "silver" filling. It is fact that mercury vaporizes in the mouth and that the vapor is inhaled and also directly absorbed into the body. It is fact that mercury travels to all body tissues and concentrates in tissues where it can do damage in several known ways. There are multiple research articles along with the literature from the Public Health Service and other material on the subject are available.

The question is not whether the above facts are true, but whether enough of it occurs to be significant. Organized dentistry in the USA has taken the position that amalgam use is perfectly safe. Those against its use have found compelling relationships to many serious illnesses ranging from depression to cancer, and from kidney disease to Alzheimer's. How can it be thought to cause so wide a range of problems? The suggested answer is that mercury from fillings doesn't cause a specific disease. It causes poisoning. And depending on which tissues it concentrates in, the symptoms will differ from one person to another. Two of the most common sites of concentration and damage, however, seem to be the brain and the kidneys.

Sweden and Germany have passed laws to stop or greatly curb the use of mercury-silver fillings. Their nationalized dental plans even help to pay for removal and replacement with alternate non-mercury materials.

Several well known institutions around the world have stopped teaching the placement of amalgams.

The Dilemma

We are faced with compelling data that the mercury in fillings may be a real hazard to our health, but both sides seem so sure about their positions.

Many dentists, myself included, share the opinion that we just don't feel comfortable using a substance designated by the EPA to be a waste disposal hazard. You cannot legally throw it in the trash, bury it in the ground, or put it in a landfill, but they say it's OK to put it in people's mouths. That just isn’t right.

Options

In the past if you wanted to avoid mercury-silver fillings your only alternative would have been gold. It looks much better than "silver" which corrodes and turns rough and black.

Porcelains, glass, and composites are newer materials that can not only restore the tooth’s function, but also its natural appearance and youthful beauty. These restorations are very natural in appearance and feel and wear very much the way natural teeth do. Obviously no material is as nice as naturally beautiful and healthy teeth, but with these materials we can come amazingly close!

The Solution

If there is even any possibility that the mercury-containing silver could be a danger to your health, and given the fact that "silver" fillings are ugly and weaken teeth and that there are now techniques available that don't seem to have any negative health potential, strengthen teeth, and look beautifully natural, then it makes no sense to have any more silver fillings placed in your mouth!

What about silver fillings already in your teeth? Certainly if you would like your teeth to look much more natural and youthful, the answer is simple. Replace the old silver. What about if your teeth have been breaking and needing root canals and caps? Again, other teeth with large silver fillings can be restored to be stronger while regaining their appearance of youth and health.

If you have silver fillings that are functionally excellent and appearance is not an issue for you, but you are concerned about possible health implications you have heard or read about regarding mercury, that is reason enough to have them replaced.

Old fillings can be replaced because they are defective or the tooth needs something stronger, or you desire something more esthetically natural and healthy looking.

Testing for Mercury Levels in Your Body

Various tests, blood, urine, hair analysis have been used to test for mercury and other heavy metals.

Methods of Testing

Intra-oral Vapor Testing A test to demonstrate the fact that mercury is present in your mouth from your mercury fillings. It's a motivator and can be a scare tactic but it doesn't show you how much mercury your body tissues are storing.
Blood and Urine Testing Again, this won't necessarily tell you the level of stored mercury. It only shows you what is presently being excreted. Blood levels can indicate recent exposure, recent excretion, or high levels.
DMPS Challenge Test A urine mercury test before and after a chelation "challenge" with DMPS that liberates mercury stored in body tissues. This is much more accurate and meaningful than plain blood or urine testing.
Hair Testing Indicates levels of mercury and other metals stored by your body over a period of time. hair closest to the scalp [newer, more recent growth] gives the most recent indication. Apparently there are many variables with hair - possibly including the kind of shampoos and conditioners etc. used - so that the alternative "experts" mostly seem to have little faith in hair analysis. I trust them since they are closer to the scientific research that checks these things out.
Skin Patch Testing - Hypersensitivity This is controversial. There are concerns that it could "sensitize" a person and make things worse. It should only be done by a medically trained professional like a dermatologist or medical allergist and should be done with ammoniated mercury [not mercury chloride].
Electrical Galvanic Testing Shows how the amalgam fillings have created a "battery" in your mouth and actually produces an electrical current that can speed the release of mercury and maybe even create havoc with acupuncture meridians. But it does not tell you how much of a problem you have with mercury toxicity or stored mercury levels.

For information on where to get the test done if you are not near my office call:

Doctors Data Inc.
PO Box 111
Chicago Illinois 60186-9986
800-323-2784
Fax 630-587-7860

Email: inquiries@doctorsdata.com

I would like to acknowledge the labors of Dr. Michael C. Goldman, of Chevy Chase, Maryland, who has organized much of this information and made it available for the general public.

Removal of Silver Fillings

If silver fillings are removed, it is important to treat it as a dangerous substance recognized by the EPA and OSHA. There are several things I can do to minimize your (and my) exposure to the mercury which is known to be released during removal of old silver fillings.

If you are under the care of a physician concerned about metal toxicity problems I can work in concert with him or her in your interest. If you are receiving alternative healthcare, I would be most happy to speak with your practitioner about these issues and work in harmony with him or her.

Differences in Tooth Preparation

Bonded vs. Amalgam Fillings

In addition to the obvious esthetic superiority of the bonded fillings, there are some very real physical advantages if well done.

When a tooth is filled with amalgam, the amalgam is just packed into a hole which is broader as it gets deeper. It is the shape of the "undercut" hole that holds the filling from falling out!!!

The amalgam is not really attached to the sides of the holes so when the tooth is stressed as in chewing or grinding, the tooth can flex away from the filling. Little cracks begin to develop. Like a crack in a car windshield, with each successive stress, the crack gets longer... until part of the too falls off!

When a bonded, tooth-colored, composite filling is properly placed, the inside surface walls of the cavity are treated chemically so the filling actually becomes attached - bonded - to the tooth. In the last drawing, tooth parts A and C are one continuous solid mass with filling material B.

Autism and Mercury Toxicity

Not too long ago an interesting paper about mercury and Autism was published in the International Journal of Toxicology, 22:277-85, 2003

It's a different twist on the long-brewing debate over autism and mercury, and it helps to explain why it has been such a confusing topic with "answers" so hard to find.

Many people have long thought there was a link between autism and mercury but finding a strong link and / or mechanism has been frustrating. Often there have been attempts to relate and quantify mercury toxicity (amount of mercury) with symptoms of autism. It didn't seem to work out. That is, a clear relationship was hard to find.

As background you should know that infants and young children that are not autistic, normally and commonly exhibit a degree of mercury contamination that is DIRECTLY RELATED to the NUMBER OF MERCURY-AMALGAM FILLINGS IN THEIR MOTHER'S MOUTH. The more amalgams Mom has, the higher the mercury in the infant. Mom's blood and breast-milk carry mercury to the baby. The more she has, the more baby gets. Whether this is viewed as good, bad, or insignificant, it's a fact to be kept in mind for this article.

Another source of mercury for children is the mercurial preservatives that have been used in vaccinations for many years (and is to some degree being phase down and hopefully, out). A third major source of mercury is diet, especially fish.

That having been said, one could expect hair analysis of infants to show a range of mercury levels that varies but in its varying, still shows relationship to the number of amalgam fillings in Mom's teeth, vaccinations, and presence or absence of fish diet.

Not surprisingly then, among normal, healthy - non-autistic - children, that is exactly what researchers have found. But what did they find when they tested Autistic children? And I mean specifically, autistic children with mothers that had lots of amalgams and often autistic children that had all the vaccinations and perhaps fish, too. Well, surprisingly they found essentially NO MERCURY!

What does that mean?

Well, since we know that normally the body at least to some extent gets rid of mercury in many ways, one of which is to get excrete it in growing hair, ...and we know the levels of mercury "gotten rid of" can be measured in the hair analysis, ....and we know these autistic children were exposed to levels of mercury that normally shows up and relates in amount to the three factors mentioned above (Mom's amalgams, vaccinations, fish), ...only one conclusion seemed possible to the researchers.

They concluded that the autistic children somehow lacked the ability to get rid of the mercury in their bodies!!! Either they lacked the mechanism to get rid of it, or their bodies somehow "held" or bound the mercury so tightly that the normal mechanisms to get rid of it couldn't work!

That strongly suggests that autistic children, unable to detoxify their mercury, build up higher body tissue levels of mercury than the non-autistic children population. The higher tissue levels of mercury toxicity may then result in neurological changes seen as symptoms of autism.

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The following are direct quotes from the research paper:

...This suggests that normal children have the ability to defend themselves against potentially toxic exposures [of mercury] and may demonstrate little negative effect despite exposures that were relatively large. By contrast, autistic infants who experience comparable exposure to mercury were completely incapable of excreting mercury through hair at levels that might have been predicted based on the excretion patterns of the control [non-autistic, "normal"] infants.

...if reduced mercury elimination is related to hair elimination [mercury found in growing hair], then autistic children will retain significantly higher levels of mercury in tissue, including the brain, than normal infants.

Root-Canal Treatment

Endodontics or root canal therapy is a process where the nerve and associated blood-vessels and lymphatics are removed from the tooth and replaced with an inert rubber material called gutta percha.

The most common reasons for needing a root canal are:

extensive tooth decay
a large cavity under a filling or crown
a dental abscess
the fracture of a tooth.

The most common symptom is a toothache.

When we suspect that the nerve is dead, we will take an x-ray to determine if there is an abscess. Sometimes, however, the abscess is not visible yet, and we have to use your description, or other secondary diagnostic signs, to decide if a root canal is needed.

There is a line of thinking among many dentists in the holistic community that root canals are necessarily bad and should never be done if you need one. They would rather see a tooth pulled, than a root canal performed under any circumstances. Before you let any dentist remove one or more of your teeth - possibly making you a dental cripple - check out what treatment options are being offered following the tooth removal and see if what is offered makes sense to you. Always remember, it's your body, and only you can decide what's right for it. Get a good understanding of the issues so you can make an informed decision about your body.

Some of the frequent questions that asked about root canals: What to do about old ones? What to do if one is now needed? While a lot has been said about potential problems with root canals, little has been offered for patients who need to make real-world, hard, practical choices, not in the abstract, but about their own bodies.

When asked, “Why would a holistic practitioner would ever advocate root canal treatment?”, Dr. Michael Goldstein a holistic practitioner in Chevy Chase, Maryland writes, It really hinges on the question of what are you going to do if you already have root canal treated teeth or if you have a tooth in need of root canal treatment?

If you just take out a tooth or teeth how are you going to replace it? Well, you may just say "I won’t replace it." That’s ok, how about if it’s a front tooth? You could choose to not replace it, but realistically most people would want to replace it.

Back teeth that "don’t show"? If you leave missing teeth missing, you may develop problems with your gums, problems with your bite (TMJ), and / or sacro-cranial problems, not to mention lowered chewing ability. I should add that in some situations, teeth can be left not replaced and everything may be fine. But that’s the exception to the rule. The fact is that most of us will want the teeth replaced for a variety of reasons.

Teeth can be replaced with removable, "clip-in" partial dentures - bridges you take in and out. Most people find them unaesthetic and unhygienic. Workable, but not very satisfactory-- Dentally, they work... but not well. Usually patients want teeth replaced in a way that is close to "natural".

They have tried to get results about what happens over time with root canal teeth that are treated by conventional means and by using the Biocalex technique. In my personal experience with Biocalex I feel it is not the way to go. There are many well-documented problems with Biocalex including splitting of teeth (preventing them from ever being saved), post-operative pain and strange discomforts, inability to re-treat the tooth again if needed later, and inability to see the results on x-rays after a period of time. I HAVE USED BIOCALEX SEVERAL TIMES AND WILL NEVER USE IT AGAIN ON MY PATIENTS.